Methods of Hysterectomies January – December 2023 at Worthing Hospital, University Hospitals Sussex

Alabdali H1, Tanwani R1, Neogi M1, Appah S1 1 Worthing Hospital, University Hospitals Sussex NHS Foundation Trust

BACKGROUND

Hysterectomy

• A major procedure

• Addresses a spectrum of conditions from o benign pathologies like fibroids and adenomyosis o malignant conditions such as endometrial or cervical cancer

• has potential to significantly impact a patient's quality of life and health.

• Approaches include

o Total laparoscopic (TLH),

o Total abdominal (TAH),

o Vaginal (VH),

o Laparoscopic assisted vaginal (LAVH)

o Subtotal abdominal (SAH).

• NICE favours a laparoscopic approach even in endometrial cancer cases, due to the shorter length of hospital stay, recovery and return to normal activity

DESIGN AND METHODS:

Data was retrospectively collected from January – December 2023 using online hospital systems, following Caldicott approval. Patient demographics, surgical indication, duration, route, complications, and length of hospital stay were analysed.

 

RESULTS

• 144 Cases 

• Average age 56

• 6.8% (5 cases) planned laparoscopic approaches converted to open

• Intraoperative complications 3.5% cases (2 TAH, 2 TLH, 1 VH) - mainly of large EBL (>300ml)

• 65% cases length of stay 1 day, 22% of 2 days

• 3 cases (2%) readmitted – bleeding/ pain

• Indications o LAVH – mainly Prolapse o VH – All prolapse o TLH – variety (Figure 2) o Abdominal – 73% Fibroids

o SAH – 67% fibroids.

 

CONCLUSIONS
• TLH techniques reduce blood loss, hospital stays,
and complications; and was the most frequent
approach.
• VH is the optimal approach for prolapse and had
the lowest complication and readmission rate.

• TAH/ SAH were the chosen approaches for emergencies and for large uterine size.

• The study emphasizes the importance of meticulous surgical planning and postoperative care to optimize outcomes and patient safety.

 

REFERENCES 1. Laparoscopic laparoscopic hysterectomy total (including hysterectomy and laparoscopically assisted vaginal hysterectomy) for endometrial cancer (no date) NICE. Available at: https ://www.nice.org.uk/guidance/ipg356

CONTACT:

Alabdali,H

huda.alabdali@nhs.net

Tanwani, H

riya.tanwani1@nhs.net